[A gravity model approach to the network of Centres for Assistance and Urgency and Emergency Department in Emilia-Romagna (Northern Italy): a tool to support equitable access planning].

IF 0.8 4区医学 Q4 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

Epidemiologia & Prevenzione Pub Date : 2026-03-01 DOI:10.19191/EP26.2.A919.036

Davide Iannuzzi, Raffaele Catananti, Antonio Fortino, Maria Pia Randazzo, Lorenzo Spinardi, Alessandro Valente, Danilo Catania

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引用次数: 0

Abstract

Background: in Emilia-Romagna Region (Northern Italy), over 60% of emergency room (ER) visits involve low-complexity cases, with a hospitalization rate of less than 5%, in line with the national trend. In 2023-2024, to improve system efficiency and ensure more appropriate use of hospital resources, the Region established 42 Centres for Assistance and Urgency (CAU) to handle minor emergencies.

Objectives: to estimate the impact of this reorganization on healthcare service accessibility developing a gravitational model based on an adapted version of the Modified Huff Three-Step Floating Catchment Area (MH3SFCA).

Design: an observational and modelling study was implemented and adapted to the healthcare context, focusing on emergency department (ED) and Centres for Asisstance and Urgency (CAU) access flows in the Emilia-Romagna Region in 2024. The study was structured into three phases: 1. calculation of access probability (using the Huff probability model); 2. estimation of the regional network's service capacity; 3. computation of the accessibility index to the network. To implement the gravitational model, distance matrices were employed - constructed on road networks - to accurately estimate travel times and distances between municipalities and healthcare facilities.

Setting and participants: admission to ERs CAUs in Emilia-Romagna in 2023-2024.

Main outcome measures: theoretical accessibility to network facilities, expressed as a composite municipal-level index; model performance assessed through R² and Weighted Mean Absolute Error (WMAE).

Results: the model integrates variables such as travel times, mobility propensity, and inter-municipal attractiveness. The results show good predictive performance and an accessibility distribution with higher values in peripheral municipalities.

Conclusions: the proposed model serves as an operational tool to support healthcare planning by assessing territorial equity in access to services and simulating alternative scenarios in the planning process.

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[对艾米利亚-罗马涅（意大利北部）援助中心和紧急及急诊部网络的重力模型方法：支持公平获取规划的工具]。

背景：在艾米利亚-罗马涅大区（意大利北部），超过60%的急诊室（ER）就诊涉及低复杂性病例，住院率低于5%，与全国趋势一致。在2023-2024年，为提高系统效率和确保更合理地使用医院资源，香港总区设立了42个急救中心，处理轻微的紧急情况。目的：评估这一重组对医疗保健服务可及性的影响，基于改进的赫夫三步浮动集水区（MH3SFCA）的改编版本开发引力模型。设计：实施了一项观察和建模研究，并对其进行了调整，以适应医疗保健背景，重点关注2024年艾米利亚-罗马涅地区的急诊科（ED）和援助和紧急中心（CAU）的访问流量。研究分为三个阶段：访问概率的计算（采用Huff概率模型）；2. 区域网络业务容量估算；3. 网络可达性指数的计算。为了实现引力模型，在道路网络上构建了距离矩阵，以准确估计城市和医疗机构之间的旅行时间和距离。环境和参与者：2023-2024年艾米利亚-罗马涅急诊室的入院情况。主要成果指标：网络设施理论可达性，用市级综合指数表示；通过R²和加权平均绝对误差（WMAE）评估模型性能。结果：该模型整合了出行时间、流动性倾向和城市间吸引力等变量。结果表明，可达性预测性能较好，外围城市可达性分布值较高。结论：拟议的模型可作为一种业务工具，通过评估获得服务的领土公平性和模拟规划过程中的备选方案，支持医疗保健规划。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Epidemiologia & Prevenzione 医学-公共卫生、环境卫生与职业卫生

CiteScore

2.60

自引率

14.30%

发文量

审稿时长

>12 weeks

期刊介绍： Epidemiologia & Prevenzione, oggi organo della Associazione italiana di epidemiologia, raccoglie buona parte delle migliori e originali esperienze italiane di ricerca epidemiologica e di studio degli interventi per la prevenzione e la sanità pubblica. La rivista – indicizzata su Medline e dotata di Impact Factor – è un canale importante anche per la segnalazione al pubblico internazionale di contributi che altrimenti circolerebbero soltanto in Italia. E&P in questi decenni ha svolto una funzione di riferimento per la sanità pubblica ma anche per i cittadini e le loro diverse forme di aggregazione. Il principio che l’ha ispirata era, e rimane, che l’epidemiologia ha senso se è funzionale alla prevenzione e alla sanità pubblica e che la prevenzione ha ben poche possibilità di realizzarsi se non si fonda su valide basi scientifiche e se non c’è la partecipazione di tutti i soggetti interessati. Modalità di comunicazione aggiornate, metodologia statistica ed epidemiologica rigorosa, validità degli studi e solidità delle interpretazioni dei risultati sono la solida matrice su cui E&P è costruita. A questa si accompagna una forte responsabilità etica verso la salute pubblica, che oggi ha ampliato in forma irreversibile il suo orizzonte, e include in forma sempre più consapevole non solo gli esseri umani, ma l’intero pianeta e le modificazioni che l’uomo apporta all’universo in cui vive. L’ambizione è che l’offerta di nuovi strumenti di comunicazione, informazione e formazione, soprattutto attraverso l''uso di internet, renda la rivista non solo un tradizionale veicolo di contenuti e analisi scientifiche, ma anche un potente strumento a disposizione di una comunità di interessi e di valori che ha a cuore la salute pubblica.